Individual
MRS. DEIDRA DIANE ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
133 SPINDER DR, EAST PEORIA, IL 61611-0016
(309) 308-5100
Mailing address
896 BANTA RD, LOWPOINT, IL 61545-7580
(309) 208-2935
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209026249
IL
Other
Enumeration date
09/14/2022
Last updated
10/26/2022
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